Bone turnover biomarkers in COPD patients randomized to either a regular or shortened course of corticosteroids: a substudy of the randomized controlled CORTICO-COP trial

Respiratory Research

Tobias W. Klausen¹  Niklas R. Jørgensen²  Ulla M. Weinreich³  Nina Godtfredsen⁴  Charlotte Suppli Ulrik⁴  Therese Lapperre⁵  Helle F. Andreassen⁵  Julie Janner⁵  Thyge L. Nielsen⁶  Philipp Schuetz⁷  Kristoffer Marså⁸  Praleene Sivapalan⁹  Karin Armbruster⁹  Josefin Eklöf⁹  Niels Seersholm⁹  Torgny Wilcke⁹  Jens-Ulrik Jensen^1,10  Pradeesh Sivapalan^1,11  Jørgen Vestbo^1,12  Alexander G. Mathioudakis^1,12 

[1] Clinical Research Unit, Department of Hematology, Herlev Hospital, Herlev, Denmark;Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark;Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; The Clinical Institute, Aalborg University, Aalborg, Denmark;Department of Respiratory Medicine, Amager and Hvidovre University Hospital, Copenhagen, Denmark;Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark;Department of Respiratory and Infectious Diseases, Frederiksund and Hillerød Hospital, University of Copenhagen, Copenhagen, Denmark;Medical University Department, Kantonsspital Aarau, 5001, Aarau, Switzerland;Faculty of Medicine, University of Basel, 4001, Basel, Switzerland;Palliative Medicine Section Unit, Herlev and Gentofte Hospital, Herlev, Denmark;Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 7, Ground Floor, DK-2900, Hellerup, Denmark;Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 7, Ground Floor, DK-2900, Hellerup, Denmark;Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 7, Ground Floor, DK-2900, Hellerup, Denmark;Department of Internal Medicine, Zealand Hospital, University of Copenhagen, Roskilde, Denmark;The North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK;Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK;

关键词: Adverse effects;    Bone remodelling;    Bone turnover markers;    Chronic obstructive pulmonary disease;    Corticosteroids;   

DOI  :  10.1186/s12931-020-01531-9

来源: Springer

【 摘 要 】

BackgroundLong-term treatment with corticosteroids causes loss of bone density, but the effects of using short-term high-dose systemic-corticosteroid therapy to treat acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are unclear. Our aim was to determine whether high-dose corticosteroid therapy affected bone turnover markers (BTMs) to a greater extent compared to low-dose corticosteroid therapy.MethodsThe CORTICO-COP trial (NCT02857842) showed that an eosinophil-guided corticosteroid intervention led to approximately 60% lower accumulated corticosteroid dose for hospitalized patients with AECOPD (low-dose group) compared with 5-day standard corticosteroid treatment (high-dose group). We compared the levels of BTMs C-terminal telopeptide of type 1 collagen (CTX) and procollagen type 1 N-terminal propeptide (P1NP) in 318 participants during AECOPD and at 1- and 3-month follow-up visits.ResultsCTX decreased and P1NP increased significantly over time in both treatment groups. There were no significant differences between the groups at 1- or 3-months follow-up for P1NP. A significant drop in CTX was seen at 3 months (down Δ24% from the baseline, p = 0.017) for the high dose group.ConclusionShort-term, high-dose systemic corticosteroid treatment caused a rapid suppression of biomarkers of bone resorption. Corticosteroids did not suppress biomarkers of bone formation, regardless of patients receiving low or high doses of corticosteroids. This therapy was, therefore, harmless in terms of bone safety, in our prospective series of COPD patients.Trial registrationClinicalTrials.gov Identifier: NCT02857842. Submitted August 2nd, 2016.

【 授权许可】

CC BY